Bulletin of RSMU

ISSN Print 2500–1094 ISSN Online 2542–1204

Bulletin of RSMU

BIOMEDICAL JOURNAL OF PIROGOV UNIVERSITY (MOSCOW, RUSSIA)

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Korolev MA, Yarmak DO, Miroschnikova EA, Moldakulov JM, Skoroglyadov AV, Korobushkin GV

Delayed or missed diagnosis of foot fractures in patients with multiple or concomitant injuries often leads to the inadequate choice of treatment and causes serious long-term effects. This article reports the most common mistakes accompanying diagnostic procedures and therapy of this injury type. The study conducted in 2007–2015 enrolled 67 patients. Patients were divided into two groups: a prospective experimental group (n = 31) and a retrospective control group (n = 36). For both groups, diagnostic procedures and the range of therapeutic interventions applied were the same, but with the experimental group we used a stepped care approach, followed a specific sequence of activities and adjusted therapy considering the limb condition and the patient’s overall state. In total, we identified 40 and 69 foot fractures in the prospective and retrospective groups, respectively. In the prospective group there were 5 delayed and 3 missed fracture diagnoses; in the second group those numbers were 7 and 9, respectively. The most common factors contributing to diagnostic errors were: excluding radiographic evaluation, severity of patient’s overall condition, poor medical history. Missed fractures were often due to a combination of various factors. A one-step approach was prevalent in the controls (41 fractures); the experimental group underwent a multistep treatment (30 fractures). Therapy outcomes were assessed by Visual Analogue Scale. The results were statistically higher in the prospective group (Mann–Whitney U was 347), which indicates a better treatment applied in this group. The study also showed that using minimally invasive fixation for foot fractures improves treatment outcome.

Received: 2016-03-30

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-03-07

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VIEWS 5984

Baboshina NV

Gas diffusion and transcapillary exchange take place in the microvasculature. Therefore, the evaluation of skin blood flow regulation and functional capacities of the microcirculatory system at various ontogenesis stages is of great importance. Using laser Doppler flowmetry in the group of boys (n = 15) and girls (n = 13) of 8 and 10 years of age, skin microcirculation and its regulatory mechanisms were evaluated. The study found an increase in the perfusion index in children between the age of 8 and 10 induced by the shifting roles of mechanisms of the microcirculatory regulation. The comparison of basal microcirculatory parameters did not display statistically significant differences related to sex in 8- and 10-year old participants. However, almost equal perfusion in boys and girls was maintained by different contributions of regulatory mechanisms. The breath holding test showed an increase in the initial microcirculation index and capillary blood flow reserve in the group of 10-year-old boys and girls. Our study revealed differences in various microcirculation parameters, in the intensity of active and passive rhythms of blood flow oscillations and response to inspiratory breath hold, which indicates age-related transformations of microcirculation system.

Received: 2016-06-01

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-03-08

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VIEWS 6500

Bokareva NA, Milushkina OYu, Ovchinnikova ZA, Pivovarov YuP, Sheina NI

Physical development and health of today’s schoolchildren are influenced by various factors, including the way the learning process is organized. This article presents data on some aspects of physical development of 1585 teenagers (15 to 17 years old) from 35 Moscow schools, including general education schools, specialized schools, schools with optional advanced courses in biomedical sciences, and health promoting schools. We studied basic anthropometric characteristics of the participants (body height and weight), assessed their psychoemotional status using the Children’s Form of Manifest Anxiety Scale and their lifestyle using questionnaire surveys. The control group included teenagers from general education schools. The study showed that the number of teenagers with no abnormalities in their physical development was significantly higher in health promoting school while the number of overweight students there was significantly lower, compared to the controls (p <0.05). For other groups of participants, the results were statistically insignificant. We established statistically significant correlations between well-proportioned physical development and the impacts of night sleep deficit (r= – 0.44, p <0.05), time spent working on the computer (r = –0.44, p <0.05), psychological climate in the family (r = –0.20, p <0.05), and meal frequency (Pearson's contingency coefficient was 0.41, with p <0.01, Cramer's contingency coefficient was 0.32, with p <0.03).

Received: 2016-05-23

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-03-09

Comments 0

VIEWS 5699

Trushina EV, Minkina OV, Dvornikov AS, Skripkina PA, fon Zimfer EI, Konyshev YaI

This article presents the results of an anonymous online survey on skin tattooing conducted in the community of medical students and professors. The article covers issues of tattoing from medical and sociocultural perspectives. The survey was carried out in Pirogov Russian National Research University and included 210 participants of different ages. The results demonstrate the insufficient knowledge of medical indications, contraindications and potential complications associated with tattooing. The obtained data can be a good starting point for developing programs aimed at raising awareness among young people, especially in higher medical institutions. The opinion expressed in this article is not necessarily shared by students and professors from other institutions for higher medical education and does not necessarily reflect the level of expertise in other medical communities. This work is an example of how socially oriented practical training can be organized for the 3rd- and 4th-year students of the Faculty of General Medicine at Pirogov Russian National Research University.

Received: 2016-05-23

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-03-10

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VIEWS 5270

Osipov LV, Dolgushin MB, Mikhaylov AI, Epel B, Rumyantsev KA, Turoverov KK, Verkhusha VV, Kulikova EYu

The rapid progress of medical sciences has brought about novel effective medications, new techniques that make surgery less traumatic, artificial materials that serve to replace tissues and organs, and robotic prostheses. Still, treatment success is largely a question of timely and accurate diagnosis and proper patient monitoring. Here, various imaging techniques come in handy. Those are often thought of as tools for anatomy visualization, but in fact, they are often highly effective for the assessment of the functional state of organs and tissues. Imaging techniques are so diverse that it is impossible to cover them all in one review. Therefore, we have decided to touch upon the most common and interesting ones, such as ultrasound imaging, tomography, oximetry and fluorescence imaging.

Received: 2016-08-15

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-04-01

Comments 0

VIEWS 5400

Klementieva NV, Furman OE, Mishin AS, Lukyanov KA, Zagaynova EV

Structural organization of actin and actin-binding proteins can be a hallmark of aggressiveness among various populations of solid tumor cells. Here, we studied the impact of chemotherapeutic drugs (paclitaxel and cisplatin) on actin and alpha-actinin structural patterns in human cervical adenocarcinoma cell culture HeLa Kyoto using total internal reflection fluorescence microscopy and single-molecule localization super-resolution microscopy. It was shown that paclitaxel causes disruption of actin cytoskeleton in cancer cells, both for actin and alpha-actinin. We observed disappearance of stress fibers, accumulation of filaments in the cell cortex and morphological changes in focal contacts. With cisplatin, we detected a lower number of thin actin bundles and more dense arrangement of alpha-actinin. Our results suggest that the actin cytoskeleton is a potential target for antitumor chemotherapy.

Received: 2016-08-15

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-04-02

Comments 0

VIEWS 5566

Sirotkina MA, Kiseleva EB, Gubarkova EV, Buyanova NL, Elagin VV, Zaitsev VYu, Matveev LA, Matveev AL, Kirillin MYu, Gelikonov GV, Gelikonov VM, Kuznetsov SS, Zagaynova EV, Gladkova ND

One of the challenges faced by modern medicine is finding new methods of functional imaging of biological tissues in patients that allow detection of early tumor response to treatment. One of such methods proposed in this work is multimodal optical coherence tomography (MM OCT). It combines cross-polarization OCT (CP OCT) for visualization of tissue structure and assessment of connective tissue health, OCT-based microangiography (OCT MA) for visualization of the vasculature, and OCT- based elastography for measuring tissue stiffness. The efficacy of this method was tested during the course of photodynamic therapy (PDT), as major PDT targets are cellular and vascular components of a tumor. The experiments were carried out on the CT26 colon carcinoma transplanted into the mouse ear. It was shown that the efficacy of PDT can be assessed using MM OCT. For example, CP OCT can help differentiate between necrotic and intact tumors; OCT MA detects blood circulation defects that lead to slower blood circulation or circulatory stagnation followed by tumor death. OCT-based elastography is helpful in assessing stiffness of normal and pathological tissues.

Received: 2016-08-15

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-04-03

Comments 0

VIEWS 5421

Tarachkova EV, Shorikov MA, Panov VO, Kuznetsov VV, Tyurin IE, Shimanovsky NL

Knowing the histology of cervical cancer (squamos cell carcinoma or adenocarcinoma) is important in deciding on the best treatment plan. We have studied the role of dynamic contrast-enhanced magnetic resonance imaging in the differential diagnosis of cervical cancer. We examined 90 patients between 23 and 78 years of age (mean age was 43.5 years) with histologically distinctive stage IIb–IVb cervical cancers. Scanning was performed on Magnetom Espree 1.5T and Magnetom Skyra 3.0T scanners (Siemens, Germany) using gadobutrol (Gadavist by Bayer, Germany). On T1-weighted images, signal intensity and its rate of change were significantly higher for adenocarcinomas compared to squamos cell carcinomas (p <0.04) from the 20th second after gadobutrol had been delivered to the tumor. With squamos cell carcinomas, the time-intensity curve (showing the dependence of signal intensity on the time elapsed after gadobutrol had been delivered to the tumor) had two phases: a short phase of a relatively slow accumulation of the contrast agent with the subsequent plateau or even signal intensity reduction. The pattern of gadobutrol accumulation allows differentiating between histological types of tumors. Based on the resulting curves, a pharmacokinetic model can be described for each tumor type. Postcontrast images are useful in determining tumor differentiation grade. Specifically, the signal from a well-differentiated adenocarcinoma is the most inhomogeneous one (p <0.03). The method described in this work does not imply that histological analysis is unnecessary and can be recommended as a supplementary diagnostic tool.

Received: 2016-08-10

Published online: 2017-01-05

DOI: 10.24075/brsmu.2016-04-04

Comments 0

VIEWS 5326